Objective To study the different effects of hypertensive putamen hemorrhage with two different treatments of decompressive craniotomy and small bone window(keyhole) surgery. Methods Retrospective analysis of 120 cases of hypertensive putamen hemorrhage in patients with operation data was carried out. They were randomly divided into two groups according to the different surgical procedure, and then compared the incidence of postoperative complications, close and long-term effects and so on. Results There was no significant difference in early complication rate and postoperative GOS score after a week between two groups(P＞0.05). The difference was significant between two groups in close and long-term effects (P ＜ 0.05 ). Conclusion Small bone window (keyhole)surgery had characteristics such as surgical time-saving ,less damage and more rapid recovery with removal of hematoma, and made played a significant role in promoting the recovery of close and long-term effects with patients.

Objective To evaluate retrospectively the efficacy of cistema magna plastic repair in the treatment of Chiari malformation complicated with syringomyelia Methods Fifty-one patients suffered from Chiari malformation complicated with syringomyelia were treated in our department from May 2004 to October 2009. Seventeen patients received cistema magna plastic repairment (the decompression of posterior cranial fossa, duraplastic repair,resection of hernia below cerebellar tonsil and separation of adherence of arachnoid membrane). Results Clinical symptoms disappeared or improved in 15 cases (effective rate of 90%). MRI showed tonsillar herniation disappeared,syringomyelia narrow. MRI showed cistema magna plastic repair, syringomyelia disappeared or significantly thinned and spinal cord subarachnoid space widened. Effective treatment obtained in 12 cases (effective rate 70%). Conclusions The efficiency of Cistern magna plastic repair treating Chiari malformation with syringomyelia is satisfied.

Chronic inflammation has been demonstrated closely related to the tumor progression.Tumorassociated macrophage,as the most abundant immune cells in the tumor microenvironment,is a key element that links inflammation and cancer.Recently,studies found that the phenomenon and function of tumor-associated macrophage almost tend to M2 type macrophage.As an important indicator,tumor-associated macrophage usually predicts the poor progress with the cancer development.In China,Most of patients with hepatocellular carcinoma are associated with chronic viral infection.A large number of macrophages in the liver infiltrated in chronic inflammation,which are differentiated by variety of mechanisms under the chronic inflammatory stimulation,promote the development of liver cancer.In this paper,we will review the tumor-associated macrophages and the development of liver cancer.

Objective To investigate the related risk factors referred to hematoma enlargement in acute stage of spontaneous cerebral hemorrhage.Methods 104 stroke patients were divided into the observation group(hematoma enlarged group) and control group (without hematoma enlarged group).The course of disease,mean arterial pressure,the bleeding amount of the first time,hematoma shape and mortality were compared between the two groups,and the risk factors of hematoma enlargement of cerebral hemorrhage patients were analyzed.Results (1) The course of disease,mean arterial pressure,hematoma shape and the bleeding amount were significantly different between the two groups(t =9.5431,11.4499,6.1847,10.7233,all P ＜ 0.05).(2) The multivariate logistic regression analysis showed that factors of influence on hematoma enlargement were mean arterial blood pressure,the course of disease and hematoma shape.(3)The mortality of the observation group was 36.53 ％,which was significantly higher than that of the control group (19.23 ％) (χ2 =3.8731,P ＜ 0.05).Conclusion High level of mean arterial blood pressure,short time of interval to onset,irregular shape of hematoma and frequent vomiting are main risk factors of hematoma enlargement in patients with intracerebral hemorrhage at acute stage.

Objective To summarize efficacy of surgical treatment of acute extradural hematoma. Methods The clinical data of 67 acute extradural hematoma(combined skull fracture) surgery cases were retrospectively analyzed from January 2006 to December 2009. Results Cerebral hernia and the time from the formation of cerebral hernia to operation affacted the prognosis of acute extradural hematoma severely. It was controversial that removal of skull bone or not after cerebral hernia. Conclusions The timely diagnosis and operation of acute extradural hematoma was positive correlation to the prognosis. The simple removal of skull bone impacted limitedly on the prognosis of patients with GCS 3.

Objective To discuss the safety and feasibility of single-incision laparoscopic appendectomy ( SILA ) . Methods A retrospective analysis was made on clinical data of patients diagnosed as having appendicitis by clinical manifestations , ultrasound or computer tomography at our department from June 2009 to December 2014.There were 189 cases of transumbilical SILA ( transumbilical group ) and 123 cases of traditional three-port laparoscopic appendectomy ( three-port group ) .Patients with incomplete records, combination with other surgery , pregnancy appendicitis , acute appendicitis over 72 hours were excluded .Intraoperative and postoperative data of two groups were compared . Results No conversion to open surgery was required in both groups .The operation time, postoperative exhaust time , and postoperative hospital stay had no significant differences between the transumbilical group and the three-port group [(45.5 ±12.7) min vs.(46.3 ±17.8) min, t=-0.461, P=0.650; (1.4 ±0.5) d vs.(1.5 ±0.6) d, t=-1.588, P=0.112;(3.8 ±1.6) d vs.(4.1 ±1.9) d, t=-1.554, P=0.121].The cosmetic scores at 3 months after surgery was higher in the transumbilical group than that in the three-port group [(4.5 ±0.6) points vs.(4.2 ±0.5) points, t=4.585, P=0.000].No significant differences were identified in the incidence of complications and pathological types between the two groups . Conclusion SILA is technically feasible and safe with better cosmetic effects .

[ Abstract] Vitamin D is a steroid derivative. It has the effect of regulating calcium -phosphorus metabolism. With the development of medicine, the effects of vitamin D in other respects, such as regulation of blood pressure, blood glucose, nerve protection, and immunity have received more and more attention. A lot of research show s that the level of vitamin D is closely associated w ith the onset and outcome of ischemic stroke. In addition, some researchers explored the relationship betw een vitamin D and stroke from the genetic perspective. How ever, the existing research results are not consistent. The link betw een vitamin D and ischemic stroke is not clear. This article review s the correlation studies of the relationship among vitamin D and vitamin D receptor gene polymorphism, the onset of ischemic stroke, outcomes and risk factors in recent years.

Objective To investigate the early diagnosis and rational treatment of popliteal artery injury so as to im-prove the lower limb salvage rate. Methods The clinical and follow-up data integrity of 25 patients with popliteal artery injury was systematically studied. In these patients , 19(76%)cases were blunt injury and 6(24%) cases were penetrating injury. The combined injury included open fracture in 10 cases(40%) ,the knee joint dislocation with closed fracture of lower limb in 13(52%),nerve injury in 5(20%) and venous injury in 3(12%),respective-ly. The cause of delayed diagnosis and relationship between prognosis and type of injury, complications, the dura-tion from injured to treatment time were analyzed. Results 20 cases were operated to repair the popliteal artery. Endovascular treatment in 5 cases, the blood supply completely recovered (64%) in 16 cases, improved in 3 cases (12%) , 6 cases (24%) amputed, respectively. Rate of amputation within 6~8 hours was significantly lower than that of the more than 8 hours from the injuried to treatment time ( P<0. 05 ) . Amputation rate in blunt injury and combined injury was significantly higher than that of sharp injury ( P<0. 05 ) . Conclusion The duration from inju-ry to surgery more than 8 h, combined with knee joint dislocation and wound around knee is a major cause of mor-bidity. Operation with arterial thrombectomy is the main treatment, while endovascular treatment is a complementa-ry treatment to save the lower limb.

Objective To explore the curative effects, side effects and complications of arterial embolization for the treatment of uterine leiomyoma.Methods Bilateral uterine arterial embolization with silk particles of 350～500 ?m was performed in 16 cases of uterine leiomyomas with uterine hemorrhage as the main complaint.Results 15 patients underwent technically successful embolization. No serious complications occurred. The patients were followed up for 3～12 months. Menses returned to regular cycle. In the patients with anemia, the hemoglobin concentration rose up to normal level. The sizes of uterine leiomyoma decreased by 52% after 6 months of the treatment.Conclusions Uterine arterial embolization is an effective and less invasive therapy with no serious complications for patients with uterine leiomyoma, especially for presentation of the uterus.

To study the clinical application of molecular diagnosis in cutaneous T-cell lymphoma (CTCL),the polymerase chain reaction Was used to detect the rearrangements of T-cell receptor (TCR)gene in 60 patients with cutaneous lymphocytic infiltrates.The result showed that dominant clonal TCR-? or ? gene rearrangements were detected in 36/40 CTCL,4/6 suspected mycosis fun- goldes/S?zary syndrome,1/1 lymphomatoid papulosis.No dominant clonal TCR-? or ? gene rearrange- ments were detected in 2 patients with CBCL,1 patient with lymphocytoma cutis,8 patient with benign lymphocytic infiltrates of skin and 2 normal controls.This study demonstrates that the method is help- ful for the lineage determination,clonality and early diagnosis of CTCL.